Should you create a dedicated health and wellness committee?
The individuals who review practitioner health issues will vary from organization to organization, and in the hospital setting, it is dependent on the structure of the medical staff. Many healthcare organizations have established a working committee specifically dedicated to matters of physician health and well-being.
Such committees became common for hospital medical staffs after The Joint Commission adopted its standard on physician health (MS.11.01.01). Although the standard does not mandate the creation of such a committee, many medical staffs have found that doing so helps them meet the various requirements of the standard. These include a responsibility to educate staff about illness and impairment recognition, provision of mechanisms to allow practitioners to self-refer for help, and mechanisms for staff to refer a suspect practitioner and for an appropriate evaluation of the concern.
An essential concept embedded in the standard is that the handling of health issues should be different from the manner in which disciplinary concerns are managed. The use of a separate committee from traditional peer review committees helps clarify the distinction. However, there is no requirement for a separate committee, and there is no reason matters of physician health cannot be addressed by an already existing and well-functioning peer review body. After all, peer review is expected to be a collegial activity and not a punitive or disciplinary one, and health issues should be treated the same way.
Many medical staffs may be too small to support yet another special function committee. Regardless, medical staff bylaws should clearly designate as a medical staff peer review body any physician health or wellness committee that will be assessing individual cases. This is to ensure that such committees will benefit from any applicable nondiscoverability provisions in state law.
There are advantages to having a dedicated physician health committee. The ability to maintain confidentiality may be greater with a small, dedicated group of members, and such a committee may be able to act more expeditiously than other committees with multiple responsibilities.
It is also possible to populate the committee with participants who have expertise in mental health, experience in managing physician impairments, useful legal knowledge, or familiarity with disability assessments. The committee can also become an advocacy group for physician wellness, creating programs to address the stress of contemporary medical practice and prevent burnout. Finally, it may be easier for members of a dedicated physician health committee to be viewed as objective experts, and therefore less likely to be accused of bias than the members on other medical staff committees.